Why do elderly diabetics burden the health care system more than non-diabetics?

Visits to general practitioners and outpatient clinics were studied among 228 known diabetics and 223 sex and age matched non-diabetic controls. Of the diabetics, 52 were treated with insulin (32 NIDDM, 20 IDDM), 101 with diet plus oral hypoglycaemic agents, and 66 with diet only. Nine were untreated. Information on visits to general practitioners and outpatient clinics during the 12 months preceding ascertainment was obtained from local and national registers. The association between number of visits, subjective symptoms and type of antidiabetic treatment was analysed. The diabetics had a higher score for subjective symptoms and a higher frequency of objective findings than controls. After controlling for these differences, the diabetics in all antidiabetic treatment groups still had a higher number of visits than non-diabetics. Insulin treated diabetics, IDDM or NIDDM, had twice as many visits to physicians due to outpatient clinic visits than the other treatment groups. The costs of treating elderly diabetics may be reduced if these patients are treated more vigorously by diet and oral hypoglycaemic agents in general practice, thus avoiding time-consuming and costly insulin treatment for some of these patients.